Abstract
This article reviews existing clinical practices and sensor research undertaken to monitor fetal well-being during labour. Current clinical practices that include fetal heart rate monitoring and fetal scalp blood sampling are shown to be either inadequate or time-consuming. Monitoring of lactate in blood is identified as a potential alternative for intrapartum fetal monitoring due to its ability to distinguish between different types of acidosis. A literature review from a medical and technical perspective is presented to identify the current advancements in the field of lactate sensors for this application. It is concluded that a less invasive and a more continuous monitoring device is required to fulfill the clinical needs of intrapartum fetal monitoring. Potential specifications for such a system are also presented in this paper.
Highlights
Introduction and Clinical MotivationFetal monitoring during labor is routinely used in high and middle-income countries to detect fetuses at risk of hypoxia, acidosis, and associated sequelae including hypoxic-ischemic encephalopathy, cerebral palsy, and death [1]
If the oxygen supply is limited, energy production is less efficient since the pyruvate is broken down if the oxygen supply is limited, energy production is less efficient since the pyruvate is broken down into lactate nicotinamide adenine dinucleotide (NAD++) by lactate dehydrogenase in the presence of into lactate nicotinamide adenine dinucleotide (NAD ) by lactate dehydrogenase in+the presence+ of the reduced form of nicotinamide adenine dinucleotide (NADH) and hydrogen (H ) ions
The risk to the mother can be reduced by using materials and approaches that mirror those used in current devices used in labor such as the FSE or fetal scalp blood sampling kits
Summary
Fetal monitoring during labor is routinely used in high and middle-income countries to detect fetuses at risk of hypoxia, acidosis, and associated sequelae including hypoxic-ischemic encephalopathy, cerebral palsy, and death [1]. Such monitoring involves intermittent or continuous fetal heart rate monitoring with external ultrasound transducers applied to the maternal abdominal wall. Continuous cardiotocography (CTG), which was invented in the 1960s [2,3], involves simultaneous assessment of the fetal heart rate and maternal uterine activity It is recommended for intrapartum monitoring in women at high risk of complications [1,4]. This review explores recent technical advances in the field of sensors that could help meet the currently unmet clinical need for continuous fetal bio-sensing during labor
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